Detection of Epilepsy based on EEG Signals using PCA with ANN Model

Epilepsy is a chronic neurological illness that affects millions of people throughout the world. Epilepsy affects around 50 million people globally. It is estimated that if epilepsy is correctly diagnosed and treated, up to 70% of people with the condition will be seizure-free. There is a need to detect epilepsy at the initial stages to reduce symptoms by medications and other strategies. We use Epileptic Seizure Recognition dataset to train the model which is provided by UCI Machine Learning Repository. There are 179 attributes and 11,500 unique values in this dataset. MLP, PCA with RF, QDA, LDA, and PCA with ANN were applied among them; PCA with ANN provided the better metrics. For the metrics, we received the following findings. It is 97.55% Accuracy, 94.24% Precision, 91.48% recall, 83.38% hinge loss, and 2.32% mean squared error.

A Midsummer Night’s Gene: The familial Neurological Illness of Felix Mendelssohn

Felix Mendelssohn Bartholdy (1805–1847) is widely regarded as one of the musical geniuses of the Romantic period. A prodigy akin to Mozart, Mendelssohn composed piano works, symphonies, and concertos at an early age but died young, at 38. His death has been attributed to neurological disease, but the mystery of his diagnosis is amplified by the fact that his sisters died under similar circumstances, including the renowned composer, Fanny Mendelssohn Hensel. Mendelssohn died after years of suffering from headaches, earaches, and mood disturbances. In the final year of his life, his acute decline was marked by stepwise, progressive neurologic deficits: gait disturbance, loss of sensation in the hands, partial paralysis, and, finally, loss of consciousness. The similar pattern of disease within his family suggests an underlying genetic link, though this may be multifactorial in nature. We present a thorough, posthumous differential diagnosis for Mendelssohn's illness, given his medical history, the familial pattern, and hints from within his music. Possible diagnoses include ruptured cerebral aneurysm with resultant subarachnoid hemorrhage, familial cerebral cavernous malformation, and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Continued research into Mendelssohn's life may yield more information about his illness, death, and possibly true diagnosis.

Neurological Manifestations of Covid-19 Hospitalized Patients In the state of Punjab, India

Introduction: COVID 19 often presents with flu-like symptoms. Elderly patients with systemic comorbidities are more likely to have severe COVID 19 infections and deaths. Severe neurological complications are frequently reported in severely and critically ill patients. In COVID-19, both central and peripheral nervous systems can be affected. The study aims to overview the spectrum, characteristics, and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: A total of 1000 confirmed CoVID-19 patients were enrolled for the study. Demographic features and initial clinical manifestations were noted, and patients were followed during the hospital stay to develop any new neurological signs and symptoms. For analytical purposes, neurological presentations were grouped into the central nervous system, peripheral nervous system, and musculoskeletal system manifestations. Appropriate laboratory testing was employed as required on a case-to-case basis. Results: The mean age was 44.6 ± 14.3 years. 625 (62.5%) patients were male, while 375 (37.5%) were female. The neurological illness was a primary manifestation in 119 (11.9%) cases. These included encephalopathy (n=78), ischemic stroke (n=28), Guillain- Barre syndrome, (n=3), facial nerve palsy (n=4), and encephalitis (n=6). The most common neurological symptoms were headache 313 (31.3%) and hyposmia 52 (5.2%), followed by encephalopathy 78 (7.8%). More serious complications like seizures 18 (1.8%) and stroke 28 (2.8%) were also seen. Conclusion: CoVID-19 can present with a neurological illness, and we should remain vigilant to the possibility of neurological presentation of COVID-19 that can be thrombo-embolic, inflammatory, or immune-mediated. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.155-161

Burnout and Stressor-Related Factors among Caretaker of Children with Chronic Neurological Illness

Objective: Caring for children with neurological conditions is challenging. This study aimed to determine the prevalence of burnout and its associated factors among caretakers of children with chronic neurological illness. Method: This cross-sectional study involved 18 years or older caretakers of children with neurological illness for more than 3 months duration. They were recruited from Paediatric Neurology outpatient clinics over a period of 3 months from July to October 2019 at a general hospital in the state of Kelantan, Malaysia. Each caretaker was given a set of questionnaires that included General Stressor Questionnaire (GSQ) which was translated into Malay version ‘Soal Selidik Umum (SSU)’, Copenhagen Burnout Inventory-Malay version (CBI-M) and Demographic Information Form. Results: Overall, only 20 caretakers had mean score of 50 or higher in all component in CBI-M, making the prevalence of total burnout among the caretakers of 8.3% (95% CI = 5.2%, 12.6%). Personal burnout involved 78 caretakers (32.5%, 95% CI = 26.6%, 38.8%), 42 caretakers with client-related burnout (17.5%, 95% CI = 12.9%, 22.9%) and 11 caretakers had work-related burnout (4.6%, 95% CI = 2.3%, 8.1%). Most common stressors were performance pressure, work-family conflict and poor job prospects. Multiple logistic regression analyses showed that family stressors, types of children’s neurological illness and number of household occupants were associated with personal burnout, client-related burnout and total burnout in their caretakers. Conclusions: Prevalence of total burnout among the caretakers was low, but personal burnout was prominent. Caretakers of children with genetic illness, cerebral palsy and autism had higher prevalence of burnout compared to other chronic neurological illness.

COVID-19 and Vaccination in the Setting of Neurologic Disease: An Emerging Issue in Neurology

The COVID-19 pandemic caused by the SARS-CoV-2 virus has left many unanswered questions for patients with neurological disorders and the providers caring for them. Elderly and immunocompromised patients are at increased risk for severe symptoms due to COVID-19, and the virus may increase symptoms of underlying neurological illness, particularly for those with significant bulbar and respiratory weakness or other neurologic disability. Emerging SARS-CoV-2 vaccines offer substantial protection from symptomatic infection, but both patients and providers may have concerns regarding theoretical risks of vaccination, including vaccine safety and efficacy in the context of immunotherapy and the potential for precipitating or exacerbating neurological symptoms. In this statement on behalf of the Quality Committee of the AAN we review the current literature, focusing on COVID-19 infection in adults with neurological disease, in order to elucidate risks and benefits of vaccination in these individuals. Based on existing evidence, neurologists should recommend COVID-19 vaccination to their patients. For those patients being treated with immunotherapies, attention should be paid to timing of vaccination with respect to treatment and the potential for an attenuated immune response.

An update on neurological outcome in Covid-19 crisis

Recent pandemic surge of Covid-19 has made it necessary to further understand a detailed neurological association with the virus in-relation to sub-clinical picture. Additionally, in the presence of a sweeping corona virus wave throughout the globe, pre-liminary studies have indicated a strong association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in addition to neuropsychiatric and neurological illness. Following a trivial research (clinical and paraclinical data), five major scenarios have been observed, namely, encephalopathies with no distinct MRI or CSF abnormalities, inflammatory CNS syndrome (including para-or-post-infections) with/out isolated myelitis, ischaemic strokes associated with pro-thrombotic state, peripheral neurological disorders such as Guillain-Barre syndrome and other miscellaneous neurological disorders. Therefore, an early recognition and understanding in the backdrop of neuropathology associated with COVID-19 is essential. Where hypercoagulability is a newfangled conduit in further complicating the pathogenesis to unreasonable levels. Here, a brief discussion on present neurology associated outcomes in COVID-19 scenario.

True “costs” of neurological illness in human immunodeficiency virus patients in a “free” health facility

Objectives: Human immunodeficiency virus (HIV) infection and neurological illness cause heavy financial burden to the patients. The economic costs of each of the disease have been reported in many studies, but the toll of both together on the patients has not been studied clearly. As neurological illnesses are seen in up to one-third of HIV patients, the combined costs need to be understood. Even with free public health services, there are out of pocket expenditures on the patients. Material and Methods: In the tertiary Government General Hospital, Guntur in India, we studied the out-of-pocket costs of time and money borne by 50 HIV-seropositive individuals hospitalized for a neurological illness during April and May 2019. We obtained data from the patients and caregivers by face-to-face oral questionnaires. Results: The median duration of HIV infection was 2.5 (IQR 0.4–7.8) years. A high proportion of our patients (20/50) was diagnosed with tuberculous meningitis. The total median time lost by each HIV-seropositive patient due to neurological illness (private consultation, travel, and hospital stay) was 27.5 (8.7–134.3) days. The total median financial burden due to neurological disease requiring hospitalization (travel, food and medicine, wages lost, private consultation expense, and loans incurred) on each patient was ₹19,150 (855–59881). Conclusion: HIV patients with neurological illness are burdened by heavy costs of time and money. They are forced into debt and lose substantial wages, most of it due to private consultation.

Digital Neuropsychological Assessment: New Technology for Measuring Subtle Neuropsychological Behavior

Technology has transformed the science and practice of medicine. In this special mini-forum, data using digital neuropsychological technology are reported. All of these papers demonstrate how coupling digital technology with standard paper and pencil neuropsychological tests are able to extract behavior not otherwise obtainable. As digital assessment methods mature, early identification of persons with emergent neurodegenerative and other neurological illness may be possible.

John Goodsir (1814–1867) and his neurological illness

John Goodsir, conservator and professor of anatomy at the University of Edinburgh, suffered an unidentified illness described by experts after his death as tabes. The features that led to this diagnosis, the understanding of tabes at that time and its relationship in some cases to syphilis, are discussed. It is concluded that the most likely diagnoses are subacute combined degeneration of the cord as a result of malnutrition or tabes dorsalis resulting from earlier syphilis. The presence of ‘lightning pains’ leans towards the latter diagnosis but evidence for a means of acquisition of syphilis is lacking. The disadvantages of retrospective diagnosis are discussed.